- Pumping Irony -

PUMPING IRONY: The Primacy of Pain

As the opioid epidemic overtakes the senior set, I’m reminded of how serious pain can overrule any internal debate over the pros and cons of painkillers.

An elderly woman holds several pills in the palm of her hand.

It’s been nearly 20 years since I last visited a hospital’s emergency room. On that occasion, I was laid low by a kidney stone that took up lodgings somewhere in my urinary tract and apparently was so pleased with the amenities that it protested any attempts at eviction. The dull pain it produced gradually grew to dispiriting levels, so My Lovely Wife drove me to the ER, where I sat doubled over in a chair hoping I could just die and get it over with.

Hours later, we returned home with a small plastic bottle that housed the opioids that became my best friends for the next week or so while my body gradually convinced its belligerent squatter to vacate the premises. Even two decades later, I fondly recall the power of those painkillers to keep discomfort at a reasonable distance.

So, even though I’ve never needed to pop a Percocet or any of its kin since then, I can understand the inclination to lean on those drugs when relief takes prominence over concerns about addiction and other side effects of the pharmaceutical solution. And it’s not surprising to learn that opioid abuse — an epidemic of monstrous proportions — is also trending here in Geezerville.

The Gerontological Society of America last week released a report showing that the number of ER visits to treat opioid misuse and dependence among the senior set more than tripled between 2006 and 2014. The results, study authors said, suggest a critical need for screening, intervention, and treatment programs specifically designed for the elderly.

And, if a recent University of Michigan/AARP survey is any indication, there’s plenty of support for such programs. Questioning more than 2,000 participants ranging in age from 50 to 80, researchers found nearly three-quarters of those polled favored limits on opioid prescriptions and other efforts to limit exposure to the painkillers. Many noted that they received no counseling from their doctors or pharmacists about the medication’s risks, how to wean themselves from the drugs, or what to do with unused pills. (We are a resourceful generation: Nearly nine in 10 of those surveyed said they kept leftover painkillers around the house just in case they might need them.)

“We know that unused medications that linger in homes are one of the primary pathways to diversion, misuse, abuse, and dependence,” Jennifer Waljee, MD, MPH, codirector of the Michigan Opioid Prescribing Engagement Network, said in a statement. “It is critically important to provide a detailed plan for patients who get opioids for pain management and resources for disposal.”

Absent such a plan, geezers have clearly begun to look for less risky pain-relief options. A 2018 survey found that 91 percent of respondents would recommend medical marijuana as an alternative to opioids to treat chronic pain.

Northwell Health researchers who conducted the poll noted that 65 percent of those surveyed said they were able to reduce their opioid usage by supplementing it with cannabinoids; nearly 30 percent were able to ditch the painkillers altogether.

“What I’m seeing in my practice, and what I’m hearing from other providers who are participating in medical marijuana programs, is that their patients are using less opioids,” study coauthor Diana Martins-Welch, MD, said in a statement. “I’ve even got some patients completely off opioids.”

This is good news for anyone hobbled by chronic pain who happens to live in one of the 30 states where medical marijuana is legal, but it’s not cheap and it’s not covered by insurance, so it’s not a viable option for many who could benefit from its pain-relief properties.

I’ve been blissfully free of the kind of soul-crushing pain that sent me to the ER back in the day, so I haven’t had to face any decisions about various remedies. But if I’m ever visited by another malevolent kidney stone, I can’t image that I’m going to be overly selective about an antidote — or much troubled by its potential consequences. Sometimes pain makes all the decisions for you.

is an Experience Life deputy editor who explores the joys and challenges of aging well.

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